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Table 3 Rank order of severity of manic symptoms by age group (symptoms are reported as mean score or  %)

From: A systematic review of the frequency and severity of manic symptoms reported in studies that compare phenomenology across children, adolescents and adults with bipolar disorders

McElroy et al. (1997)a Birmaher et al. (2009)b,c Safer et al. (2012)a
Mean ± SD Mean ± SD POMPd (%)
Adolescent Adult Child Adolescent Child/adolescent Adult
Increased motor activity
 (2.5 ± 1.4)
Bizarre/grandiose thought content (3.2 ± 1.4) High energy (4.3 ± 1.4) High energy (4.8 ± 1.0) Irritability (17) Grandiosity (16)
Delusions
 (2.1 ± 1.7)
Delusions (2.7 ± 1.4) Increased motor activity (4.3 ± 1.2) Decreased need for sleep (4.5 ± 1.7) Aggression (15) Rapid speech (16)
Bizarre/grandiose thought content
 (2.1 ± 1.9)
Thought disturbance (2.2 ± 1.6) Irritability (4.1 ± 1.5) Elation (4.4 ± 1.0) Rapid speech (15) Irritability (14)
Thought disturbance
 (1.4 ± 1.6)
Sleep disturbance (1.9 ± 1.2) Mood lability (4.1 ± 1.1) Increased motor activity (4.3 ± 1.1) Grandiosity (10) Motor activity (10)
Sleep disturbance
 (1.3 ± 1.3)
Increased motor activity (1.8 ± 1.4) Elation (3.9 ± 1.2) Accelerated speech (4.2 ± 1.1) Motor activation (9) Elevated mood (9)
Increased goal directed/aggressive behaviour
 (0.8 ± 1.1)
Increased goal directed/aggressive behaviour (1.1 ± 1.2) Accelerated speech (3.9 ± 1.2) Poor judgement (4.0 ± 1.6);
Racing thoughts (4.0 ± 1.3)
Elevated mood (9) Aggression (9)
  1. N.B. The range of possible scores for YMRS and K-MRS items differ, so mean scores are not directly comparable for similar symptoms
  2. a Young Mania Rating Scale (YMRS); b K-SADS Mania Rating Scale (K-MRS)
  3. c Most items are from the YMRS, but ‘delusions’ and ‘bizarre/grandiose thought content’ were from the Scale for Assessment of Positive Symptoms
  4. d POMP = Percent of maximum possible score; All  % are reported to the nearest integer